Skip to main content
SpringerLink
Log in

Labour Market Status and Well-Being in the Context of Return to Work After Vocational Rehabilitation in Germany

  • Published:
Journal of Occupational Rehabilitation Aims and scope Submit manuscript

Abstract

Introduction Although there is much empirical evidence for a given relationship between health and labour market status (LMS), the following study focuses on a group for which little is known in the German context: people with disabilities in vocational rehabilitation for the purpose of re-integration into the labour market. In this specific context, the article analyses how a change in LMS affects physical, mental and general health. Methods Using a panel survey, 857 people with disabilities in vocational rehabilitation and their subjective health condition were observed between 2008 and 2010. To reduce bias due to unobserved heterogeneity, fixed-effects panel regression is applied. Results Results show that a move from non-employment to employment positively affects—particularly general—subjective health. In addition to LMS, the level of occupational limitation due to disability appears to be of particular relevance in estimating health. Interacting both the level of occupational limitation and LMS reveals that non-employed people reporting serious occupational limitation due to their disability have the worst subjective health across all aspects. However, people in employment experiencing similarly serious limitations due to their disability do not differ much from this group. These may be regarded as having taken up disability–inappropriate employment. Conclusion The results suggest that re-integration into employment particularly improves several health aspects if rehabilitants are integrated in an occupational environment where disability does not present an occupational limitation. Thus, placement in disability–appropriate employment needs to be particularly encouraged.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Notes

  1. There have been studies on the process of vocational rehabilitation for different institutions providing programmes of vocational rehabilitation [7–9], however, there is scarcely known about the admission to and the long term success of vocational rehabilitation.

  2. In this article, rehabilitants always refers to rehabilitants for whom the FEA is responsible.

  3. E.g., the Statutory Pension Insurance is mainly responsible for people who have worked longer than 15 years.

  4. As people considered unemployed are institutionally defined as searching for a job, they are often assumed to be particularly committed to employment. Thus, distress of the unemployed is caused by the incongruent situation inherent in the status itself [21]. This might be particularly true for the present population who generally seek re-integration into the labour market.

  5. The survey was carried out by the Institute for Applied Social Sciences GmbH (infas).

  6. First integrated people refer to young people who usually have no vocational training and no vocational experience and pursue a first integration into the labour market. They are not focused in the present study.

  7. Adjusting weights are used for the description of the population.

  8. The English questions of the SF-12 Health Survey can be found in Ware et al. [33]. The German version of all items can be found in Nübling et al. [34].

  9. Further independent variables are controlled for. If relevant for measuring health, these variables are mentioned in the results section.

  10. Though some people (seven percent) state that they are not disabled, the characteristic disabled is a prerequisite for being eligible for vocational rehabilitation. Rehabilitants might not consider themselves disabled or might be uncomfortable in stating a disability [42].

  11. During vocational rehabilitation many different programmes are available. The main measure is defined in accordance with a hierarchy of programmes. E.g., programmes for the purpose of (re-)training and further training are preferred over taster programmes introducing different jobs, since they reflect the main strategy of placement officers.

  12. Although general health is a non-continuous variable, it is common practice to apply FE linear regression to refer to the marginal effects from the coefficients displayed, since marginal effects cannot be predicted using FE logit regression [43].

References

  1. Jahoda M. Employment and unemployment: a social-psychological analysis. Cambridge: Cambridge University Press; 1982.

    Google Scholar 

  2. Alavinia SM, Burdorf A. Unemployment and retirement and ill-health: a cross-sectional analysis across European countries. Int Arch Occup Environ Health. 2008;82:39–45.

    Article  PubMed Central  PubMed  Google Scholar 

  3. Peter R, Geißler H, Siegrist J. Associations of effort-reward imbalance at work and reported symptoms in different groups of male and female public transport workers. Stress Med. 1998;14(3):175–82.

    Article  Google Scholar 

  4. Karasek RA, Theorell T. Healthy work. Stress, productivity and the reconstruction of working life. New York: Basic Books; 1990.

    Google Scholar 

  5. Siegrist J, Dragano N. Berufliche Belastungen und Gesundheit [occupational strain and health]. Wendt, Claus; Wolf, Christof (Hrsg): Soziologie der Gesundheit Wiesbaden: VS Verlag für Sozialwissenschaften. 2006;S109–124.

  6. Lindberg P. The work ability continuum. Epidemiological studies of factors promoting sustainable work ability. Stockholm: Karolinska Institutet; 2006.

    Google Scholar 

  7. Dony E, Gruber S, Alaa J, Rauch A, Schmelzer P, Schneider A et al. Basisstudie zur Evaluation von Leistungen zur Teilhabe behinderter Menschen am Arbeitsleben [feasability-study for the evaluation of benefits for the participation of disabled people in the labour market] * Basisstudie "Reha-Prozessdatenpanel" [base-study rehabilitationprocess-data-panel]. Zusammenfassender Bericht (Teil A). Berlin2012 Contract No.: 427.

  8. Beyersdorf J, Rauch A. Junge Rehabilitanden zwischen Schule und Erwerbsleben - Maßnahmen der beruflichen Ersteingliederung anhand empirischer Befunde aus der IABPanelbefragung der Rehabilitanden 2007 und 2008 [young rehabilitants between school and labour market participation – empirical evidence for measures targeted at disabled people in first labour market integration using the IAB-panelsurvey of rehabilitants for 2007 and 2008]. Nürnberg: IAB; 2012.

  9. Streibelt M, Egner U. Eine Meta-Analyse zum Einfluss von Stichprobe, Messmethode und Messzeitpunkt auf die berufliche Wiedereingliederung nach beruflichen Bildungsleistungen [a meta-analysis of the impact of sample, kind of outcome measurement and time of follow up on occupational re-integration after vocational retraining]. Die Rehabilitation. 2012;51(6):398–404.

  10. Federal Ministry of Labour and Social Affairs. Social Security at a Glance. 2014. http://www.bmas.de/SharedDocs/Downloads/DE/PDF-Publikationen/a998-social-security-at-a-glance-total-summary.pdf?__blob=publicationFile.

  11. DiPrete T, McManus PA. Family change, employment transitions, and the welfare state: household income dynamics in the United States and Germany. Am Sociol Assoc. 2000;65(3):343–70.

    Article  Google Scholar 

  12. Riphahn RT. Older workers’ responses to health shocks. Berlin: DIW; 1997 (Contract No.: 1).

  13. Kohler U, Ehlert M, Grell B, Heisig JP, Radenacker A, Wörz M. Verarmungsrisiken nach kritischen Lebensereignissen in Deutschland und den USA [Poverty risks after critical life events in Germany and the United States]. Kölner Zeitschrift für Soziologie und Sozialpsychologie. 2012;64(64):223–45. doi:10.1007/s11577-012-0164-7.

    Article  Google Scholar 

  14. Paul K, Moser K. Negatives psychisches Befinden als Wirkung und als Ursache von Arbeitslosigkeit [negative mental well-being as effect of and cause for unemployment]. In: Zempel J, Bacher J, Moser K, editors. Erwerbslosigkeit: Ursachen, Auswirkungen und Interventionen. Opladen: Leske & Budrich; 2001. p. 83–110.

  15. Pech E, Freude G. Zusammenhang zwischen eingeschränktem Gesundheitszustand und Arbeitslosigkeit [correlation between limited health condition and unemployment]. 2010. http://d-nb.info/1012328465/34. Accessed 04 June 2013.

  16. Elkeles T. Gesundheitliche Ungleichheit am Beispiel Arbeitslosigkeit und Gesundheit – Befunde, Erklärungen und Interventionsansätze [health inequality by the example of unemployment and health]. In: Bauer U, Bittlingmayer M, editors. Health Inequalities. Wiesbaden: VS Verlag für Sozialwissenschaften; 2008. p. 87–107.

  17. Warr P. Work, unemployment, and mental health. Oxford: Oxford University Press; 1987.

    Google Scholar 

  18. Hackman JR, Oldham GR. Work redesign. Organization development. Reading: Addison-Wesley; 1980.

    Google Scholar 

  19. Warr P. Work, happiness and unhappiness. Mahwah NJ: Lawrence Erlbaum; 2007.

    Google Scholar 

  20. Paul K, Moser K. Arbeitslosigkeit. In: Moser K, editor. Wirtschaftspsychologie. Heidelberg: Springer; 2007. p. 285–305.

    Chapter  Google Scholar 

  21. Paul K, Moser K. Incongruence as an explanation for the negative mental health effects of unemployment. Meta-analytic evidence. J Occup Organ Psychol. 2006;79:595–621.

    Article  Google Scholar 

  22. Job Spence M, Signaling Market. Q J Econ. 1973;87(3):355–74.

    Article  Google Scholar 

  23. Turner JB, Turner RJ. Physical disability, unemployment, and mental health. Rehabil Psychol. 2004;49(3):241–9.

    Article  Google Scholar 

  24. Eggs J. Unemployment benefit II, unemployment and health, vol 12. IAB-discussion paper. 2013.

  25. Schmitz H. Why are the unemployed in worse health? The causal effect of unemployment on health. Labour Econ. 2011;18:71–8.

    Article  Google Scholar 

  26. Murphy GC, Athanasou JA. The effect of unemployment on mental health. J Occup Organ Psychol. 1999;72(1):83–99.

    Article  Google Scholar 

  27. Bartley M, Sacker A, Clarke P. Employment status, employment conditions, and limiting illness: prospective evidence from the British Household Survey 1991–2001. J Epidemiol Community Health. 2004;58:501–6.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  28. Schuring M, Mackenbach T, Voorham T, Burdorf A. The effect of re-employment on perceived health. J Epidemiol Community Health. 2011;65:639–44.

    Article  CAS  PubMed  Google Scholar 

  29. Burdorf A. The importance of solid employment for health. Scand J Work Environ Health. 2008;34(2):81–2.

    Article  PubMed  Google Scholar 

  30. Graetz B. Health consequences of employment and unemployment: longitudinal evidence for young men and women. Soc Sci Med. 1993;36(6):715–24.

    Article  CAS  PubMed  Google Scholar 

  31. Holler M, Trischler F. Gute Erwerbsbiographien [good employment biografies]: working paper 3; Einflussfaktoren auf die Arbeitsfähigkeit; der Einfluss belastender Arbeitsbedingungen auf die Gesundheit und die Arbeitsfähigkeit bis zum Rentenalter [determinants of working ability; the impact of occupational strain on health and working ability up to retirement age]. Stadtbergen; 2010.

  32. Llena-Nozal A. The effect of work status and working conditions on mental health in four OECD countries. Natl Inst Econ Rev. 2009;209:72–87.

    Article  Google Scholar 

  33. Ware JE, Kosinski M, Keller SD. A 12-Item Short-Form Health Survey—construction scales and preliminary tests of reliability and validity. Med Care. 1996;34(3):220–33.

    Article  PubMed  Google Scholar 

  34. Nübling M, Andersen HH, Mühlbacher A. Entwicklung eines Verfahrens zur Berechnung der körperlichen und psychischen Summenskalen auf Basis der SOEP-Version des SF 12 (Algorithmus) [the development of a procedure to calculate physical and mental scales based on the SOEP-version of the SF-12]. Data Documentation DIW. 2006;16:1–14.

  35. Salyers MP, Bosworth HB, Swanson JW, Lamb-Pagone J, Osher FC. Reliability and validity of the SF-12 Health Survey among people with severe mental illness. Med Care. 2000;38(11):1141–50.

    Article  CAS  PubMed  Google Scholar 

  36. Cheak-Zamora NC, Wyrwich KW, McBride TD. Reliability and validity of the SF-12v2 in the medical expenditure panel survey. Qual Life Res. 2009;18:727–35.

    Article  PubMed  Google Scholar 

  37. Borg V, Kristensen TS, Burr H. Work environment and changes in self-rated health: a five year follow-up study. Stress Medicine. 2000;16:37–47.

    Article  Google Scholar 

  38. Brüderl J. Kausalanalyse mit Paneldaten [causal analysis using panel data]. In: Christof W, Henning B, editors. Handbuch der sozialwissenschaftlichen Datenanalyse. Wiesbaden: VS Verlag für Sozialwissenschaften; 2010. p. 963–94.

  39. Allison PD. Fixed effects regression models. Quantitative applications in the social sciences, vol. 160. Los Angeles: Sage; 2009.

    Google Scholar 

  40. Dauth W, Hirschenauer F, Rüb F. Vergleichstypen 2008 – Neufassung der SGB III Typisierung [comparison types 2008 – new version of the social code III typing]. In: IAB Forschungsbericht 8/2008. Nürnberg; 2008.

  41. Stock JH, Wright JH, Yogo M. A survey of weak instruments and weak identification in generalized method of moments. Am Stat Assoc. 2002;20(4):518–29.

    Article  Google Scholar 

  42. Johansson P, Skedinger P. Are objective, official measures of disability reliable? Stockholm: The Research Institute of Industrial Economics; 2005.

    Google Scholar 

  43. Wooldridge JM. Econometric analysis of cross section and panel data. Cambridge: MIT Press; 2010.

    Google Scholar 

  44. Kroll LE, Lampert T. Sozialkapital und Gesundheit in Deutschland [Social capital and health in Germany]. Gesundheitswesen. 2007;69:120–7.

    Article  CAS  PubMed  Google Scholar 

  45. Dalgard O, Dowrick C, Lehtinen V, Vazquez-Barquero J, Casey P, Wilkinson G, et al. Negative life events, social support and gender difference in depression. Soc Psychiatry Epidemiol. 2006;41(6):444–51. doi:10.1007/s00127-006-0051-5.

    Article  Google Scholar 

  46. Polanyi M, Tompa E. Rethinking work-health models for the new global economy: a qualitative analysis of emerging dimensions of work. Work J Prev Assess Rehabil. 2004;23(1):3–18.

    Google Scholar 

  47. Hogan A, Kyaw-Myint SM, Harris D, Denronden H. Workforce participation barriers for people with disability. Int J Disabil Manag. 2012;7:1–9.

    Article  Google Scholar 

Download references

Conflict of interest

Nancy Reims and Ulrike Bauer declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Institute for Employment Research, Regensburger Straße 104, 90478, Nuremberg, Germany

    Nancy Reims & Ulrike Bauer

Authors
  1. Nancy Reims
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ulrike Bauer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nancy Reims.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Reims, N., Bauer, U. Labour Market Status and Well-Being in the Context of Return to Work After Vocational Rehabilitation in Germany. J Occup Rehabil 25, 543–556 (2015). https://doi.org/10.1007/s10926-014-9561-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10926-014-9561-2

Keywords

Search

Navigation